Surprise! Medicaid Dental Reimbursement Rates Drop by 2.5% on September 1

You just found out about this? So did we.

Just learned of it

TDMR learned of it about 10 days ago when a provider gave us a copy of a letter they received from DentaQuest dated July 27 but received in their office August 13.  It announced a 2.5% reduction on dental codes from D2140 to D9999 that was approved at a “recent” HHSC rate hearing.  What?   We knew nothing about a “recent” hearing.

Incredibly, the provider has heard nothing from MCNA.  Another provider who contacted TDMR today told us they had called their MCNA rep who didn’t know about the reductions and would look into it.  Pretty damn confusing.

Rate hearing was under the radar

Here is the story which we were fortunate to piece together after talking to others.  It went under our radar and apparently just about everyone else’s too.

Remember last December just before Christmas, HHS announced a rate hearing to be held January 11 about minor dental rate changes to take effect January 1.   It appeared this was the major rate change discussed earlier in 2017 but wasn’t.  The poor timing of the announcement certainly created an uproar.

Well, this time on April 19, TMHP did the announcing of a rate change hearing instead of HHSC (we still don’t know whether to call them HHS or HHSC when TMHP and HHS still refer to HHS as HHSC).  It put a notice up on its website that such a hearing was being held May 3 on these September 1 reimbursement changes.  Here is the notice.

Tada!  Here we are a few days before September 1 and dental providers are just finding out about it.

The documents to download

Here is the document that came out of that rate hearing with the rate adjustments.


Here is the letter sent out from DentaQuest which was apparently on the ball on this one.



Happy Labor Day weekend!




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